CoGenesis® Pan-Cancer
123-gene hereditary pan-cancer panel across 10 NCCN-informed subpanels
CoGenesis® Pan-Cancer is a comprehensive germline test for people whose personal or family history does not fit only one hereditary cancer syndrome. Instead of ordering several single-gene tests sequentially, this panel analyzes 123 genes across 10 curated hereditary cancer subpanels in one workflow. The panel includes well-established high- and moderate-risk genes linked to hereditary breast and ovarian cancer, Lynch syndrome and other colorectal or polyposis syndromes, hereditary diffuse gastric cancer, prostate cancer, endocrine neoplasia, renal cancer, pheochromocytoma or paraganglioma, childhood tumor predisposition, and additional solid-tumor susceptibility genes.
Examples include BRCA1, BRCA2, PALB2, ATM, and CHEK2 for hereditary breast-related risk; MLH1, MSH2, MSH6, PMS2, and EPCAM for Lynch syndrome; APC, BMPR1A, SMAD4, POLD1, and POLE for polyposis and early-onset colorectal cancer syndromes; CDH1 and CTNNA1 for hereditary diffuse gastric cancer; TP53 and PTEN for broader cancer-predisposition syndromes; and RAD51C, RAD51D, BRIP1, and HOXB13 for ovarian or prostate risk pathways.
- Patients with a personal or family history spanning more than one hereditary cancer pattern, where a single-syndrome test may be too narrow.
- Early-onset cancer, multiple primary cancers, bilateral or multifocal disease, rare tumors, or several affected relatives across generations.
- Simultaneous assessment for hereditary breast and ovarian cancer, Lynch syndrome, polyposis, hereditary gastric cancer, pancreatic or prostate risk, endocrine neoplasia, and related solid-tumor syndromes.
- Planning surveillance, genetics referral, risk-reducing strategies, and cascade testing for relatives.
- Multidisciplinary review when germline findings may influence treatment discussion or research eligibility.
- Not a standalone test for diagnosing an active cancer or determining tumor stage.
- Not a substitute for pathology, imaging, colonoscopy, endoscopy, or other organ-specific evaluations when cancer is suspected.
- Not designed for somatic tumor profiling, liquid biopsy, or treatment selection without germline and clinical context.
- Not able to predict the exact age of onset, penetrance, or severity for every carrier.
- Not able to exclude hereditary risk completely when the family history remains strongly suggestive.
10 sub-panels included:
| Step / Test | Accuracy | Notes |
|---|---|---|
| Variant calling – SNP | >99.9% | |
| Variant calling – Indel | >99% |
4mL Peripheral blood (EDTA), 2mL saliva, or buccal swab
- Preferred specimen: 4 mL peripheral blood collected in an EDTA tube.
- Acceptable alternatives: Codex-provided saliva kit (2 mL) or 4 Codex-provided buccal swabs.
- Label each specimen with patient identifiers and collection date before shipment.
- For saliva or buccal swab collection, do not eat, drink, smoke, chew gum, or brush teeth for 30 minutes before sampling.
EDTA whole blood should be stored at 4-8°C and delivered within 48 hours of collection; do not freeze. Saliva and buccal swab specimens are stable at room temperature for up to 7 days.
- Insufficient DNA yield or poor DNA quality.
- Missing or incorrect patient identifiers, or mismatch between specimen and request form.
- Contaminated, leaking, degraded, or improperly stored specimens.
- Incorrect specimen type, incorrect collection device, or samples received outside validated stability limits.
Samples must be collected and submitted by a licensed healthcare professional.
- Keep Blood samples at 4–8°C after collection; avoid freezing, deliver within 48 hours of collection.
- Saliva or buccal swabs are stability in room temperature for up to 7 days. Address: Unit 220, 2/F, Building 16W, HKSTP, Pak Shek Kok, NT, Hong Kong. Tel: +852 3008 2560
- Pathogenic or likely pathogenic variants are reported with gene-specific cancer associations and guideline-informed management context where relevant.
- Variants of uncertain significance (VUS) should not be used alone to direct risk-reducing surgery or intensified screening; management should continue to rely on personal and family history unless the variant is reclassified.
- A negative result reduces but does not eliminate inherited risk, especially when family history remains strongly suggestive.
- Cascade testing of at-risk relatives and formal genetic counseling are recommended after clinically significant findings.
Hereditary cancer syndromes account for a clinically important minority of common cancers, but the differential diagnosis can overlap substantially. The same family may present with breast, ovarian, pancreatic, prostate, colorectal, gastric, uterine, endocrine, renal, or skin tumors, making sequential single-gene testing inefficient. Multigene germline panels are most useful when more than one syndrome is plausible or when management-relevant genes span several pathways.
Clinical value lies in gene-specific management rather than a single pooled risk score. Depending on the gene identified, Guideline-informed care (e.g. NCCN) may include earlier breast MRI or mammography, colonoscopic surveillance, upper gastrointestinal surveillance, pancreatic screening in selected carriers, prostate screening, consideration of risk-reducing salpingo-oophorectomy, or syndrome-specific counseling for relatives. Because penetrance differs by gene, variant classification and phenotype correlation remain essential, and genetics referral is best practice for result disclosure and family management.
— NCCN 2026.3Multigene germline testing is particularly useful when a personal or family history could fit more than one hereditary cancer syndrome.
— NCCN 2026.3Findings in BRCA1/2, PALB2, ATM, CHEK2, TP53, Lynch syndrome genes, APC, CDH1, and related pathways can change surveillance, cascade testing, and risk-reducing care.
Hong Kong-based molecular diagnostics laboratory specialising in clinical genomics, precision oncology, and rare disease diagnosis. Accredited to ISO 27001 and GenQA standards.
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